| 1. |
- Hasselberg, Marie, et al.
(författare)
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I did NOT feel like this at all before the accident : do men and women report different health and life consequences of a road traffic injury?
- 2019
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Ingår i: Injury Prevention. - : BMJ. - 1353-8047 .- 1475-5785. ; 25:4, s. 307-312
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Worldwide, injuries represent one of the leading causes of mortality, and nearly one-quarter of all injuries are road traffic related. In many high-income countries, the burden of road traffic injuries (RTIs) has shifted from premature death to injury and disability with long-term consequences; therefore, it is important to assess the full burden of an RTI on individual lives.OBJECTIVE: To describe how men and women with minor and moderate injuries reported the consequences of an RTI on their health and lives.METHODS: The study was designed as an explorative qualitative study, in which the answers to an open-ended question concerning the life and health consequences following injury were analysed using systematic text condensation.PARTICIPANTS: A total of 692 respondents with a minor or a moderate injury were included.RESULTS: The respondents reported the consequences of the crash on their health and lives according to four categories: physical consequences, psychological consequences, everyday life consequences and financial consequences. The results show that medically classified minor and moderate injuries have detrimental long-term health and life consequences. Although men and women report some similar consequences, there are substantial differences in their reported psychological and everyday life consequences following an injury. Women report travel anxiety and PTSD-like symptoms, being life altering for them compared with men, for whom these types of reports were missing.CONCLUSION: These differences emphasise the importance of considering gender-specific physical and psychological consequences following an RTI.
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| 2. |
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| 3. |
- Ahlm, Kristin, 1956-
(författare)
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Traffic and drowning incidents with emphasis on the presence of alcohol and drugs
- 2014
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Worldwide, fatal traffic injuries and drowning deaths are important problems. The aim of this thesis was to investigate the cirumstances of fatal and non-fatal traffic injuries and drowning deaths in Sweden including analysis of the presence of alcohol and drugs, which are considered to be major risk factors for these events. Data where obtained from the database of National Board of Forensic Medicine.In the first study, we investigated 420 passenger deaths from 372 crashes during 1993-1996. There were 594 drivers involved. In total, 21% of the drivers at fault were alcohol positive compared to 2% of drivers not at fault (p<0.001) (Paper I). During 2004-2007, crashes involving 56 fatally and 144 non-fatally injured drivers were investigated in a prospective study from Northern Sweden (Paper II). The drivers were alcohol positive in 38% and 21%, respectively. Psychoactive drugs were found in 7% and 13%, respectively. Benzodiazepines, opiates and antidepressants were the most frequent drugs found in drivers. Illict drugs were found 9% and 4% respectively, with tetrahydrocannabinol being the most frequent of these drugs (Paper II).We investigated 5,125 drowning deaths in Sweden during 1992-2009 (Paper III). The incidence decreased on average by about 2% each year (p<0.001). Unintentional drowning was most common (50%). Alcohol was found in 44% of unintentional, 24% of intentional, and 45% of undetermined drowning deaths. Psychoactive substances were detected in 40% and benzodiazepines were the most common substance. Illicit drugs were detected in 10%. Of all drowning deaths, a significantly higher proportion females commited suicide compared with males (55% vs. 21%, p<0.001). Suicidal drowning deaths (n=129) in Northern Sweden were studied further in detail (Paper IV). of these, 53% had been hospitalized due to a psychiatric diagnosis within five years prior to the suicide. Affective and psychotic disorders were the most common psychiatric diagnoses. Almost one third had performed a previous suicide attempt. One fourth had committed suicide after less than one week of discharge from hospital. Alochol was found in 16% and psychoactive drugs in 62% of these cases, respectively. In conclusion, alcohol and psychoactive drugs are commonly detected among injured drivers and drowning victims, and probably play a role in these events. Most of the individuals that tested positive for alcohol and high blood concentrations, indicating alochol dependence or abuse. This association warrants futher attention when planning future prevention.
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| 4. |
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| 5. |
- Backe, Stefan, 1963-
(författare)
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Safety promotion and injury surveillance with special focus on young people´s club sports : Challenges and possibilities
- 2014
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Physical activity in youth has many benefits, but parallel to these benefits, sport related injuries pose considerable risks. It is important to public health to address sport related injuries, particularly those affecting young people, who comprise the majority of participants in organised sport in Sweden. The first study in this research showed that inspections of local sport environments, where injuries often occur, did not occur uniformly. Two additional studies pointed out the need for better surveillance of injuries, and described the use of ambulance attendance reports as a possible improvement to current surveillance systems, with a possibility to improve safety for youth and other sport participants. Two other studies identify risk factors that were specific to football and climbing sports, which can be used to guide targeted safety interventions for the young participants of these sports. The studies, taken as a whole, provide new information about the factors associated with sport related injuries, particularly for young people, and point out the need for better sport injury surveillance, improved inspection strategies for fields maintained by organised sport clubs in local communities, and the need to address risk factors specific to different sport activities.
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| 6. |
- Bidgoli, Hassan Haghparast, et al.
(författare)
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Pre-hospital trauma care resources for road traffic injuries in a middle-income country-A province based study on need and access in Iran.
- 2011
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Ingår i: Injury. - : Elsevier BV. - 0020-1383 .- 1879-0267. ; 42:9, s. 879-884
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Access to pre-hospital trauma care can help minimize many of traffic related mortality and morbidity in low- and middle-income countries with high rate of traffic deaths such as Iran. The aim of this study was to assess if the distribution of pre-hospital trauma care facilities reflect the burden of road traffic injury and mortality in different provinces in Iran. METHODS: This national cross-sectional study is based on ecological data on road traffic mortality (RTM), road traffic injuries (RTIs) and pre-hospital trauma facilities for all 30 provinces in Iran in 2006. Lorenz curves and Gini coefficients were used to describe the distributions of RTM/RTIs and pre-hospital trauma care facilities across provinces. Spearman rank-order correlation was performed to assess the relationship between RTM/RTI and pre-hospital trauma care facilities. RESULTS: RTM and RTIs as well as pre-hospital trauma care facilities were distributed unequally between different provinces. There was no significant association between the rate of RTM and RTIs and the number of pre-hospital trauma care facilities across the country. CONCLUSIONS: The distribution of pre-hospital trauma care facilities does not reflect the needs in terms of RTM and RTIs for different provinces. These results suggest that traffic related mortality and morbidity could be reduced if the needs in terms of RTM and RTIs were taken into consideration when distributing pre-hospital trauma care facilities between the provinces.
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| 7. |
- Dale, Richard Allan, 1965, et al.
(författare)
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Alcohol environment, gender and nonfatal injuries in young people. An ecological study of fourteen swedish municipalities (2000-2005).
- 2012
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Ingår i: Substance abuse treatment, prevention, and policy. - 1747-597X. ; 7:1
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Tidskriftsartikel (refereegranskat)abstract
- ABSTRACT: BACKGROUND: Sweden has had a restrictive alcohol policy, but there are gender and geographical differences in alcohol consumption and injury rates within the country. Whether and how the Swedish alcohol environment influences gender differences in injuries in young people is still unclear. Thus, the aim of this study was to analyse the associations between the local alcohol environment and age- and gender-specific nonfatal injury rates in people up to 24 years in Sweden. METHODS: The local alcohol environment from 14 municipalities was studied using indicators of alcohol access, alcohol consumption and alcohol-related crimes. A comprehensive health care register of nonfatal injuries was used to estimate mean annual rates of nonfatal injuries by gender and age group (2000--2005). Pearson's correlation coefficients were used to analyse linear associations. RESULTS: Associations were shown for both alcohol access and alcohol consumption with injury rates in boys aged 13--17 years; no other associations were observed between alcohol access or per capita alcohol consumption and nonfatal childhood injuries. The prevalence of crimes against alcohol laws was associated with injury rates in children of both genders aged 6--17 years. CONCLUSIONS: This study found no strong area-level associations between alcohol and age and gender specific nonfatal injuries in young people. Further, the strength of the area-level associations varied by age, gender and type of indicator used to study the local alcohol environment.
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| 8. |
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| 9. |
- Haghparast-Bidgoli, Hassan, et al.
(författare)
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Factors affecting hospital length of stay and hospital charges associated with road traffic-related injuries in Iran
- 2013
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Ingår i: BMC Health Services Research. - : Springer Science and Business Media LLC. - 1472-6963. ; 13, s. Article Number: 281-
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Tidskriftsartikel (refereegranskat)abstract
- Background: Road traffic injuries (RTIs) are a substantial cause of mortality and disability globally. There is little published information regarding healthcare resource utilization following RTIs, especially in low and middle-income countries (LMICs). The aim of this study was to assess total hospital charges and length of stay (LOS) associated with RTIs in Iran and to explore the association with patients' socio-demographic characteristics, insurance status and injury-related factors (e. g. type of road users and safety equipment). Method: The study was based on the Iranian National Trauma Registry Database (INTRD), which includes data from 14 general hospitals in eight major cities in Iran, for the years 2000 to 2004. 8,356 patients with RTI admitted to the hospitals were included in the current study. The variables extracted for the analysis included total hospital charges and length of stay, age, gender, socio-economic and insurance status, injury characteristics, medical outcome and use of safety equipment among the patients. Univariable analysis using non-parametric methods and multivariable regression analysis were performed to identify the factors associated with total hospital charges and LOS. Results: The mean hospital charges for the patients were 1,115,819 IRR (SD=1,831,647 IRR, US$128 +/- US$210). The mean LOS for the patients was 6.8 (SD =8 days). Older age, being a bicycle rider, higher injury severity and longer LOS were associated with higher hospital charges. Longer LOS was associated with being male, having lower education level, having a medical insurance, being pedestrian or motorcyclist, being a blue-collar worker and having more severe injuries. The reported use of safety equipment was very low and did not have significant effect on the hospital charges and LOS. Conclusion: The study demonstrated that the hospital charges and LOS associated with RTI varied by age, gender, socio-economic status, insurance status, injury characteristics and health outcomes of the patients. The results of the study provide information that can be of importance in the planning and design of road traffic injury control strategies.
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| 10. |
- Hasselberg, Marita, et al.
(författare)
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Breastfeeding preterm infants at a neonatal care unit in rural Tanzania
- 2016
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Ingår i: Journal of Obstetric, Gynecologic and Neonatal Nursing. - : Elsevier BV. - 0884-2175 .- 1552-6909. ; 45:6, s. 825-835
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To describe the breastfeeding experiences of mothers with preterm and low-birth-weight infants in a neonatal unit in Tanzania.DESIGN: A qualitative research design.SETTING: A neonatal unit at a referral hospital in rural Tanzania.PARTICIPANTS: Convenience sample of 10 new mothers with preterm infants. Additionally, to triangulate the data, five nurses affiliated with the neonatal unit were interviewed.METHODS: A semistructured interview guide was used for data collection. All interviews were audiotaped and transcribed verbatim. Data were analyzed with inductive qualitative content analysis.RESULTS: One main category, The mother has to adapt to the new situation to make breastfeeding natural, and three generic categories, The challenges of breastfeeding a premature infant, Enhancing the feeding situation, and The need for support, were used to describe breastfeeding challenges. Challenges consisted of the perception that the infant was different than healthy infants and the infant's and mother's health problems and needs. To improve the feeding situation, mothers learned how to feed their infants using timing strategies. Confidence and security were achieved with support from family and friends, the other mothers, and the health care staff.CONCLUSION: Mothers perceived breastfeeding as natural but needed support to overcome the challenges of breastfeeding preterm infants. Through support and education they were empowered, adapted to their new situations, and felt confident with breastfeeding.
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| 11. |
- Hasselberg, Marie
(författare)
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The social patterning of road traffic injuries during childhood and youth : national longitudinal register-based studies
- 2004
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Apart from being the primary cause of death during childhood and adolescence, scientific evidence points in the direction that road traffic injuries make a major contribution to social inequalities in health during this period of life. The aim of the thesis is to advance knowledge and understanding of social differences in road traffic injury morbidity among young people in Sweden. The thesis is composed of five register-based nation wide cohort studies. In the first study, socioeconomic group of the household is studied in relation to hospital-based road traffic injuries as pedestrians, bicyclists, moped-riders, motorcyclists and car drivers, for the period 19871994 (when subjects were aged 2-24 years). Morbidity differences between groups are observed in all categories of road users, but most prominently among motorized-vehicle drivers. In spite of more injuries occurring among boys than girls, similar social patterning emerges for both sexes. The following two studies investigate whether the social distribution of road traffic injuries for different age groups and for different types of road users varies according to how socioeconomic position of the family is measured. Consideration is paid to parental education, socioeconomic group of the household (based on occupation) and household disposable income. Among young children (Study II), road traffic injuries as pedestrians, bicyclists, and car passengers are studied for the years 1991-1999, and among older ones (Study III), road traffic injuries as car drivers for the years 1991-1996. The groups were followed respectively up to 14 years and up to 23 years. It is observed that both parental socioeconomic group and parental education impact on the risk of road traffic injuries in the two age groups. By contrast, disposable income of the household is a risk factor of greater importance among the younger ones. Studies IV and V focus on young adult car drivers and distinguish their socioeconomic position of origin, based on the socioeconomic group of the household, and their position of destination, considering subject's educational attainment at age 28-30 years. In study IV, the social patterning of injury repeaters is examined as compared to that of the once-injured, based on in-patient treatment when subjects were aged 18-26 years, an age period otherwise at high risk of injuries as car drivers. The study shows that injury repeaters as car drivers are uncommon and that their social patterning is much similar to that of once-injured drivers. For Study V, car-to-car and single crashes are analysed, paying attention to various injury severity levels (consequences) and various crash patterns (circumstances). Crash data come from the police reports for the period 1988-2000, i.e., when subjects were 18-30 years. Relative risks of road traffic injuries are compiled considering age at licensing of the subjects. Socioeconomic differences appear clearly for both crash consequences and crash circumstances. The excess risk for young drivers from lower socioeconomic groups is more pronounced as severity increases. Whereas gender modifies the effect of socioeconomic position of destination, it does not modify the effect of socioeconomic position of origin. The results of the studies forming the thesis suggest differences in the impact of road traffic injuries among children and young people from different socioeconomic group in Swedish society. Further, the excess risk for young drivers from lower socioeconomic groups is consistent across crash severity levels, and becomes more pronounced as severity increases.
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| 12. |
- Jonsson, Anders, 1967-
(författare)
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Dödsbränder i Sverige : En analys av datakvalitet, orsaker och riskmönster
- 2018
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Risken att omkomma genom brand har mer än halverats under de senaste 60 åren i Sverige. Det är idag mycket ovanligt att små barn omkommer i brand men samma positiva utveckling kan inte ses för de äldre. En åldrande befolkning som i ökande omfattning förväntas bo kvar hemma innebär att denna grupp måste prioriteras i framtida brandskyddsarbete. Sambearbetning av data från tre nationella register visar att rutinmässigt framtagen statistik systematiskt underskattar den verkliga situationen. Män, äldre, ensamboende och ekonomiskt svaga är särskilt riskutsatta grupper att omkomma vid bostadsbränder och förekomst av alkohol bland offren är mycket vanligt. Den i särklass vanligaste brandorsaken är rökning. Trots att varje dödsbrand är unik kan det omfattande materialet beskrivas av relativt få och tydligt avgränsade typer av händelser som var och en måste mötas med relevanta preventiva insatser. Avhandlingen visar att dödsbränder i bostäder i huvudsak är ett socialt problem och att det kommer att krävas uthålliga och breda strategier, bestående både av sociala och tekniska åtgärder för att skydda de mest riskutsatta och sårbara människorna i samhället.
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| 13. |
- Klingberg, Anders, et al.
(författare)
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mHealth for Burn Injury Consultations in a Low-Resource Setting : An Acceptability Study Among Health Care Providers
- 2020
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Ingår i: Telemedicine journal and e-health. - : Mary Ann Liebert Inc. - 1530-5627 .- 1556-3669. ; 26:4, s. 395-405
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: The rapid adoption of smartphones, especially in low- and middle-income countries, has opened up novel ways to deliver health care, including diagnosis and management of burns. This study was conducted to measure acceptability and to identify factors that influence health care provider's attitudes toward m-health technology for emergency care of burn patients. Methods: An extended version of the technology acceptance model (TAM) was used to assess the acceptability toward using m-health for burns. A questionnaire was distributed to health professionals at four hospitals in Dar Es Salaam, Tanzania. The questionnaire was based on several validated instruments and has previously been adopted for the sub-Saharan context. It measured constructs, including acceptability, usefulness, ease of use, social influences, and voluntariness. Univariate analysis was used to test our proposed hypotheses, and structural equation modeling was used to test the extended version of TAM. Results: In our proposed test-model based on TAM, we found a significant relationship between compatibility-usefulness and usefulness-attitudes. The univariate analysis further revealed some differences between subgroups. Almost all health professionals in our sample already use smartphones for work purposes and were positive about using smartphones for burn consultations. Despite participants perceiving the application to be easy to use, they suggested that training and ongoing support should be available. Barriers mentioned include access to wireless internet and access to hospital-provided smartphones.
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| 14. |
- Värnild, Astrid, 1944-
(författare)
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Seriously injured road users in rural and urban road traffic in a Swedish region - a Vision Zero perspective
- 2020
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Globally more than 50 million people are injured in road traffic every year. The incidence of road injuries is increasing while that of fatalities is decreasing. Road safety measures are being implemented in many countries to reduce the effects on public health. In highly motorized countries, the process is often managed by quantitative targets. Sweden has a target for 2020 based on Vision Zero: that no-one should be killed or seriously injured in road traffic. In Vision Zero, pedestrians in single crashes are not defined as road users, even when they move in the same areas as road users with vehicles. In this thesis the road space (pavements, tracks and roads) defines the road user.The aim of the thesis is to study the development of serious injuries in rural and urban areas during a period when Vision Zero was being implemented through government efforts to direct the process in Sweden. The thesis adopts a regional perspective. Three of the four studies in the thesis are cross-sectional studies with data from Region Västmanland during twelve to fifteen years, 2003–2017. Data are also based on analyses of ten regional infrastructure plans in Sweden for the period 2014–2025.On national roads in the region, the incidence of serious injuries decreased for car occupants, but on regional roads it increased. In urban areas the incidence for unprotected road users doubled on roads and more than doubled on tracks and pavements where the greatest number of unprotected road users are seriously injured. One factor in the increased incidence is the growing number of elderly people in the population caused by the large generation born in the 1940s and a lengthening lifespan. From 2012 the probability of being seriously injured increased for cyclists and pedestrians 80 years and older, and from 2015 for the group 65 years and older.In urban areas during the period, there was a shift in serious injuries for pedestrians and cyclists from less head injuries to more injuries in lower extremities. The probability of receiving serious injuries to the lower extremities increased fourfold from the age of 50 for both pedestrians and cyclists, but for cyclists the probability increased with age.For pedestrians, pavements and tracks were associated with decreased probability of all injuries except for head injuries, but for cyclists this decrease is only seen for the most severe injuries. For pedestrians, the probability of getting injuries in more than one bodily region decreased on Vision Zero roads.Prioritized investments in regional plans are mostly justified by accessibility and increased walking and cycling, and only more sparsely by road safety. This reflects an imbalance in the government’s clarifications of the transport goals.In directives for regional planning and in support of the objectives of Agenda 2030, the government has argued for more active mobility. There is a need to include pedestrian falls in the category of single crashes in the work with Vision Zero. Increased walking and cycling justifies more road safety measures especially in urban areas in order to achieve the targets of Vision Zero. To achieve Vision Zero it is important that the concerned road authorities and regions are committed to the goals and fulfil their tasks. More active mobility in combination with an increased number of older people is a challenge for municipalities as road authorities in urban areas.
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| 15. |
- Wallis, Lee, et al.
(författare)
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A roadmap for the implementation of mHealth innovations for image-based diagnostic support in clinical and public-health settings : a focus on front-line health workers and health-system organizations
- 2017
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Ingår i: Global Health Action. - : TAYLOR & FRANCIS LTD. - 1654-9716 .- 1654-9880. ; 10
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Tidskriftsartikel (refereegranskat)abstract
- Background: Diagnostic support for clinicians is a domain of application of mHealth technologies with a slow uptake despite promising opportunities, such as image-based clinical support. The absence of a roadmap for the adoption and implementation of these types of applications is a further obstacle. Objectives: This article provides the groundwork for a roadmap to implement image-based support for clinicians, focusing on how to overcome potential barriers affecting front-line users, the health-care organization and the technical system. Methods: A consensual approach was used during a two-day roundtable meeting gathering a convenience sample of stakeholders (n = 50) from clinical, research, policymaking and business fields and from different countries. A series of sessions was held including small group discussions followed by reports to the plenary. Session moderators synthesized the reports in a number of theme-specific strategies that were presented to the participants again at the end of the meeting for them to determine their individual priority. Results: There were four to seven strategies derived from the thematic sessions. Once reviewed and prioritized by the participants some received greater priorities than others. As an example, of the seven strategies related to the front-line users, three received greater priority: the need for any system to significantly add value to the users; the usability of mHealth apps; and the goodness-of-fit into the work flow. Further, three aspects cut across the themes: ease of integration of the mHealth applications; solid ICT infrastructure and support network; and interoperability. Conclusions: Research and development in image-based diagnostic pave the way to making health care more accessible and more equitable. The successful implementation of those solutions will necessitate a seamless introduction into routines, adequate technical support and significant added value.
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